Alshamsi F, Alshammari K, Belley-Cote E, et al. - Researchers analyzed data from randomized controlled trials (RCTs) in order to investigate whether extracorporeal liver support (ECLS) affords an effective and safe management choice in cases of liver failure. They analyzed overall 25 RCTs (1,796 patients) identified from MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials explored from inception through March 13, 2019. The included RCTs were those that compared ECLS to usual care in acute liver failure (ALF) or acute on chronic liver failure (ACLF). Evaluation of the certainty of the evidence was done by using the Grading of Recommendations Assessment, Development and Evaluation approach. According to the findings, mortality attenuation and improvement in hepatic encephalopathy may be brought about by ECLS in patients with ALF and ACLF. However, as far as the impacts of ECLS on hypotension, bleeding, thrombocytopenia and line infection are concerned, the results were uncertain.